Preoperative STOP-BANG Scores and Postoperative Delirium and Coma in Thoracic Surgery Patients
- PMID: 30244705
- PMCID: PMC6886685
- DOI: 10.1016/j.athoracsur.2018.05.089
Preoperative STOP-BANG Scores and Postoperative Delirium and Coma in Thoracic Surgery Patients
Abstract
Background: Obstructive sleep apnea (OSA) is associated with higher rates of postoperative delirium. The relationship between preoperative OSA risk and postoperative delirium and coma in thoracic surgery patients hospitalized in the intensive care unit (ICU) is not well understood. This study tests the hypothesis that thoracic surgery patients hospitalized in ICU with a higher preoperative risk for OSA are more likely to develop postoperative delirium and coma, resulting in longer hospital stays.
Methods: Preoperative OSA risk was measured using the STOP-BANG questionnaire. STOP-BANG scores of greater than or equal to 3 were defined as intermediate-high risk for OSA; 128 patients who underwent major thoracic surgery completed the STOP-BANG questionnaire preoperatively. The Richmond Agitation and Sedation Scale was used to assess level of consciousness. The Confusion Assessment Method for the ICU was used to assess for delirium. Linear regression was used to assess the relationship between risk of OSA and outcome measures. Results were adjusted for age, sex, body mass index, Charlson Comorbidity Index, instrumental activities of daily living, and surgery type.
Results: A total of 96 of 128 patients (76%) were in the intermediate-high-risk OSA group. Adjusted analyses showed that the intermediate-high-risk OSA group had a longer duration of postoperative ICU delirium and coma compared with the low-risk OSA group (1.4 ± 1.3 days versus 0.9 ± 1.4 days; P = 0.04). Total number of hospital days was not significantly different.
Conclusions: Higher preoperative risk for OSA in thoracic surgery patients was associated with a longer duration of postoperative delirium and coma.
Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Comment in
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Preoperative stratification for postoperative delirium: obstructive sleep apnea is a predictor, the STOP-BANG is not?J Thorac Dis. 2019 Mar;11(Suppl 3):S202-S206. doi: 10.21037/jtd.2019.02.33. J Thorac Dis. 2019. PMID: 30997176 Free PMC article. No abstract available.
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How can we reduce the incidence of postoperative mental disorders after thoracic surgery?J Thorac Dis. 2019 Mar;11(Suppl 3):S207-S209. doi: 10.21037/jtd.2019.02.22. J Thorac Dis. 2019. PMID: 30997177 Free PMC article. No abstract available.
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Obstructive sleep apnea and perioperative delirium among thoracic surgery intensive care unit patients: perspective on the STOP-BANG questionnaire and postoperative outcomes.J Thorac Dis. 2019 May;11(Suppl 9):S1292-S1295. doi: 10.21037/jtd.2019.04.63. J Thorac Dis. 2019. PMID: 31245113 Free PMC article. No abstract available.
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Is obstructive sleep apnea related to postoperative delirium, postoperative, coma or both?J Thorac Dis. 2019 May;11(Suppl 9):S1320-S1321. doi: 10.21037/jtd.2019.04.50. J Thorac Dis. 2019. PMID: 31245121 Free PMC article. No abstract available.
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